Assuta Medical Center, Tel Aviv, Israel.
The Azrieli Faculty of Medicine Safed, Bar-Ilan University, Ramat Gan, Israel.
Obes Surg. 2023 Mar;33(3):695-705. doi: 10.1007/s11695-022-06436-8. Epub 2023 Jan 3.
Reports of long-term (> 5-15-year) outcomes assessing the safety and efficacy of primary revisional laparoscopic sleeve gastrectomy (LSG) are few.
Retrospective long-term comparisons of primary (pLSG) and revisional (rLSG) procedures were matched for gender, age ± 5 years, and body mass index (BMI) ± 5 kg/m. Weight loss, associated medical condition status, and patient satisfaction were evaluated.
Between May 1, 2006, and December 31, 2016, 194 matched patients with severe obesity (mean BMI 44.1 ± 6.7 kg/m; age 44.2 ± 10.0 years, 67.0% female) underwent pLSG (n = 97) or rLSG (n = 97) and were followed for a mean 12.1 ± 1.5 vs 7.6 ± 2.1 years. Respective mean weight regain from nadir was 15.0 ± 14.4 kg vs 11.9 ± 12.2 kg. Respective percent mean total weight loss and excess weight loss were 20.9 ± 12.7% and 51.8 ± 33.1%, and 18.3 ± 12.8% and 43.4 ± 31.6% at last follow-up, with no significant difference between groups. Resolution of type 2 diabetes (HbA1 < 6.5%, off medications) was 23.1% vs 11.1%; hypertension 36.0% vs 16.0%; and hyperlipidemia 37.1% vs 35.3%. Patients in the pLSG group were significantly more satisfied with LSG (59.8% vs 43.3%, p < 0.05) and more likely to choose the procedure again.
There were no significant differences in long-term weight loss or associated medical condition outcomes in matched pLSG and rLSG patients.
关于初次修正腹腔镜袖状胃切除术（LSG）的长期（>5-15 年）安全性和疗效的报告很少。
对初次（pLSG）和修正（rLSG）手术进行回顾性长期比较，并按性别、年龄（±5 岁）和体重指数（BMI）（±5kg/m）进行匹配。评估体重减轻、相关疾病状况和患者满意度。
2006 年 5 月 1 日至 2016 年 12 月 31 日，194 例严重肥胖患者（平均 BMI 44.1±6.7kg/m；年龄 44.2±10.0 岁，67.0%为女性）接受了 pLSG（n=97）或 rLSG（n=97）治疗，并随访了平均 12.1±1.5 年和 7.6±2.1 年。各自的体重从最低点的恢复分别为 15.0±14.4kg 和 11.9±12.2kg。各自的平均体重减轻百分比和多余体重减轻百分比分别为 20.9±12.7%和 51.8±33.1%，18.3±12.8%和 43.4±31.6%，两组之间无显著差异。2 型糖尿病（HbA1<6.5%，停药）缓解率为 23.1%和 11.1%；高血压缓解率为 36.0%和 16.0%；高血脂缓解率为 37.1%和 35.3%。pLSG 组的患者对 LSG 明显更满意（59.8%和 43.3%，p<0.05），且更可能再次选择该手术。
在初次 pLSG 和 rLSG 患者中，长期体重减轻或相关疾病状况结果无显著差异。
